All right, Roger — Roger Runningen. Roger, it’s his birthday, by the way. That’s not the reason you got a question, but I thought it was important to note that. Happy birthday.
Q: Thank you, Mr. President. Back to health care, can you guarantee for the American people that the health care website is going to be fully operational for all people — not just the vast majority — by November 30? And second, more broadly, this is your signature domestic piece of legislation.
PRESIDENT OBAMA: Right.
Q: You hear criticism on the Hill that you and your White House team are too insular. Is that how this mess came to be?
PRESIDENT OBAMA: Well, you know, I think there’s going to be a lot of — there’s going to be a lot of evaluation of how we got to this point. And I’m — I assure you that I’ve been asking a lot of questions about that. (Chuckles.) The truth is that this is, number one, very complicated. You know, the website itself is doing a lot of stuff.
There aren’t a lot of websites out there that have to help people compare their possible insurance options, verify income to find out what kind of tax credits they might get, communicate with those insurance companies so that they can purchase, make sure that all of it’s verified, right? So there’s just a — a bunch of pieces to it that made it challenging.
And you combine that with the fact that the federal government does a lot of things really well. One of the things it does not do well is information technology procurement. You know, this is kind of a systematic problem that we have across the board.
And you know, it is not surprising, then, that there were going to be some problems. Now, I think we have to ask ourselves some hard questions inside the White House, as opposed to why we didn’t see more of these problems coming earlier on, A, so we could set expectations, B, so that we could look for different ways for people to end up applying.
So, you know, ultimately, you’re right. This is something that’s really important to me, and it’s really important to millions of Americans who have been waiting for a really long time to try go get health care because they don’t have it. And you know, I am very frustrated, but I’m also somebody who, if I fumble the ball, you know, I’m going to wait until I get the next play, and then I’m going to try to run as hard as I can and do right by the team. So, you know, ultimately I’m the head of this team. We did fumble the ball on it. And what I’m going to do is make sure that we get it fixed.
In terms of what happens on November 30th or December 1st, I think it’s fair to say that the improvement will be marked and noticeable. You know, the website will work much better on November 30th, December 1st, than it worked certainly on October 1st. That’s a pretty low bar. It’ll be working a lot better than it is — it was last week and will be working better than it was this week, which means that the majority of people who go to the website will see a website that is working the way it’s supposed to.
I think it is not possible for me to guarantee that a hundred percent of the people a hundred percent of the time going on this website will have a perfectly seamless, smooth experience.
We’re going to have to continue to improve it, even after November 30th, December 1st. But the majority of people who use it will be able to see it operate the way it was supposed to.
One thing that we’ve discovered, though, that I think is — is worth noting, a lot of focus has been on the website and the technology, and that’s partly because that’s how we initially identified it; you know, these are glitches. What we’re discovering is that part of the problem has been technology, hardware and software, and that’s being upgraded. But even if we get the — the hardware and software working exactly the way it’s supposed to with relatively minor glitches, what we’re also discovering is that insurance is complicated to buy. And another mistake that we made, I think, was underestimating the difficulties of people purchasing insurance online and shopping for a lot of options with a lot of costs and lot of different benefits and plans and — and somehow expecting that that would be very smooth, and then they’ve also got to try to apply for tax credits on the website.
So what we’re — what we’re doing even as we’re trying to solve the technical problems is also what can we do to make the application a little bit simpler? What can we do to make it in English as opposed to bureaucratese? Are there steps that we can skip while still getting the core information that people need?
And part of what we’re realizing is that there are going to be a certain portion of people who are just going to need more help and more hand-holding in the application process.
And so — so I guess part of the continuous improvement that I’m looking at is not just a technical issue; it’s also can we streamline the application process; what are we doing to give people more assistance in the application process; you know, how do the call centers and the people who are helping folks in person — how are they trained so that things can go more smoothly, because the bottom line ultimately is I just want people to know what their options are in a — in a clear way. And you know, buying health insurance is never going to be like buying a song on iTunes. You know, it’s just a much more complicated transaction.
But I think we can continue to make it better, all of which is to say that on December — or December 1st, November 30th, it will be a lot better, but there will still be some problems. Some of those will not be because of technological problems, although I’m — I’m sure that there will still be some glitches that have to be smoothed out. Some of it’s going to be how are we making this application process more user-friendly for folks.
And you know, one — one — one good example of this, by the way, just to use an analogy — when we came into office, we heard a lot of complaints about the financial aid forms that families had to fill out to get federal financial aid. And I actually remember applying for some of that stuff and remember how difficult and confusing it was.
And Arne Duncan over at Education worked with a team to see what we could do to simplify it, and it made a big difference. And that’s part of the process that we’ve got to go through. And in fact, you know, if we can get some focus groups and we sit down with actual users and see, you know, how well is this working, what would improve it, what part of it didn’t you understand, that all, I think, is part of what we’re going to be working on in the weeks ahead.
Q: What about the insularity criticism that you hear on the Hill?
PRESIDENT OBAMA: You know, I — I’ve got to say I meet with an awful lot of folks, and I talk to an awful lot of folks every day. And I have lunches with CEOs and IT venture capitalists and labor leaders and, you know, pretty much folks from all walks of life on a whole bunch of topics. And if you looked at my schedule on any given day, we’re interacting with a whole lot of people.
And I think it’s fair to say that we have a pretty good track record of working with folks on technology and IT from our campaign, where, both in 2008 and 2012, we did a pretty darn good job on that. So it’s not that — you know, the idea that somehow we didn’t have access or were interested in people’s — people’s ideas I think isn’t accurate.
What is true is that, as I said before, our IT systems, how we purchase technology in the federal government is cumbersome, complicated and outdated. And so this isn’t a situation where — on my campaign, I could simply say, who are the best folks out there, let’s get them around a table, let’s figure out what we’re doing and we’re just going to continue to improve it and refine it and work on our goals.
If you’re doing it at the federal government level, you know, you’re going through, you know, 40 pages of specs and this and that and the other and there’s all kinds of law involved. And it makes it more difficult — it’s part of the reason why chronically federal IT programs are overbudget, behind schedule.
And one of the — you know, when I do some Monday morning quarterbacking on myself, one of the things that I do recognize is since I know that the federal government has not been good at this stuff in the past, two years ago as we were thinking about this, you know, we might have done more to make sure that we were breaking the mold on how we were going to be setting this up. But that doesn’t help us now. We got to move forward.
Jeff Mason.
Q: Thank you, Mr. President. Today’s fix that you just announced leaves it up to state insurance commissioners and insurance companies to ultimately decide whether to allow those policies to be renewed for a year. How confident are you that they will do that? And secondly, how concerned are you that this flawed rollout may hurt Democrats’ chances in next year’s mid-term elections and your ability to advance other priorities, such as immigration reform?
PRESIDENT OBAMA: On the first question, traditionally state insurance commissioners make decisions about what plans can be or cannot be sold, how they interact with insurers. What we’re essentially saying is the Affordable Care Act is not going to be the factor in what happens with folks in the individual market. And my guess is right away you’re going to see a number of state insurance commissioners exercise it.
Part of the challenge is the individual markets are different states. There’s some states that have individual insurance markets that already have almost all the consumer protections that the Affordable Care Act does. They match up pretty good.
It’s not some big jump for — for folks to move into the marketplace. In others, there are pretty low standards, so you can sell pretty substandard plans in those markets, and that’s where people might see a bigger jump in their premiums. So I think there’s going to be some state-by-state evaluation on how this is handled.
But the key point is, is that it allows us to be able to say to the folks who’ve received these notices, look, you know, I, the president of the United States, and the insurance — the insurance model of the Affordable Care Act is not going to be getting in the way of you shopping in the individual market that you used to have. Now, as I said, there are still going to be some folks who, over time, I think, are going to find that the marketplaces are better.
One way I — I described this to — I met with a group of senators when this issue first came up. And it’s not a perfect analogy, but you know, we made a decision as a society that every car has to have a seat belt or air bags. And so you pass a regulation. And there’s some additional cost, particularly at the start, of increasing the safety and protections, but we make a decision as a society that the costs are outweighed by the benefits of all the lives that are saved. So what we’re saying now is if you’re buying new — a new car, you got to have a seat belt.
Well, the problem with the — the grandfather clause that we put in place is it’s almost like we said to folks, you got to buy a new car, even if you can’t afford it right now. And sooner or later folks are going to start trading in their old cars.
But, you know, we don’t need — if their life circumstance is such where, for now at least, they want to keep the old car, even if the new car is better, we should be able to give them that option, and that’s what we want to do.
And by the way, that’s what we should have been able to do in drafting the rules in the first place. So again, you know, these are two fumbles on something that — on a big game which — but the game’s not over. With respect to the politics of it, you know, I’ll let you guys do a lot of the work on projecting what this means for various political scenarios.
There is no doubt that our failure to roll out the ACA smoothly has put a burden on Democrats, whether they’re running or not, because they stood up and supported this effort through thick and thin, and, you know, I feel deeply responsible for making it harder for them rather than easier for them to continue to promote the core values that I think led them to support this thing in the first place, which is, in this country, as wealthy as we are, everybody should be able to have the security of affordable health care.
And that’s why I feel so strongly about fixing it. My first and foremost obligation is to the American people, to make sure that they can get what’s there if we can just get the darn website working and smooth this thing out, which is plans that are affordable and allow them to advantage of tax credits and give them a better deal.
But I also do feel an obligation to everybody who — out there who supported this effort. You know, when we don’t do a good job on the rollout, we’re letting them down. And, you know, I don’t — I don’t like doing that. So my commitment to them is we’re going to just keep on doing better every day until we get it done.
And in terms of the impact on me — I think to some extent I addressed it when I talked to Julie (sp) — you know, there are going to be ups and downs during the course of my presidency. And, you know, I think I said early on when I was running, I am not a perfect man and I will not be a perfect president, but I’ll wake up every single day working as hard as I can on behalf of Americans out there from every walk of life who are working hard, meeting their responsibilities but sometimes are struggling because the way the system works isn’t giving them a fair shot.
And — and that pledge I haven’t broken. That commitment, that promise continues to be — continues to hold; the promise that I wouldn’t be perfect, number one, but also the promise that as long as I’ve got the honor of having this office, I’m just going to work as hard as I can to make things better for folks.
And what that means specifically in this health care arena is we can’t go back to the status quo. I mean, right now everybody is properly focused on us not doing a good job on the rollout. And that’s legitimate and I get it.
There have been times where I thought we were — got, you know, slapped around a little bit unjustly. This one’s deserved, all right? It’s on us.
But we can’t lose sight of the fact that the status quo before the Affordable Care Act was not working at all. If — if the health care system had been working fine and everybody had high-quality health insurance at affordable prices, I wouldn’t have made it a priority. We wouldn’t have been fighting this hard to get it done, which is why when I see sometimes folks up on Capitol Hill, and Republicans in particular, who have been suggesting, you know, repeal, repeal, let’s get rid of this thing, I keep on asking, well, what is it that you want to do? Are you suggesting that the status quo was working? Because it wasn’t, and everybody knows it. It wasn’t working in the individual market, and it certainly wasn’t working for the 41 million people who didn’t have health insurance.
And so what we did was we chose a path that was the least disruptive to try to finally make sure that health care is treated in this country like it is in every other advanced country, that it’s not some privilege that just a certain portion of people can have, but it’s something that everybody has some confidence about. And you know, we didn’t go far left and choose an approach that would have been much more disruptive. We didn’t adopt some more conservative proposals that would have been much more disruptive. We tried to choose a way that built off the existing system.
But it is complicated. It is hard. But I make no apologies for us taking this on because somebody, sooner or later, had to do it.
I do make apologies for not having executed better over the last several months.
Q: Do you think that execution and the — and the flaws in the rollout will affect your ability to do other things, like immigration reform, another policy (priority ?)?
PRESIDENT OBAMA: Well, look, if — if — (if ?) it comes to immigration reform, you know, there is no reason for us not to do immigration reform. And we’ve already got strong bipartisan support for immigration reform out of the Senate. You’ve got — I met with a number of traditionally very conservative clergy who are deeply committed to immigration reform. We’ve got the business community entirely behind immigration reform. So you’ve got a bunch of constituencies that are traditionally much more — have leaned much more heavily towards Republicans who are behind this.
So if people are looking for an excuse not to do the right thing on immigration reform, they can always find an excuse. You know, we’ve run out of time or, you know, this is hard or, you know, the list goes on and on. But my working assumption is people should want to do the right thing. And when you’ve got an issue that would strengthen borders, make sure that the legal immigration system works the way it’s supposed to, that would go after employers who are doing the wrong thing when it comes to hiring undocumented workers and would allow folks who are here illegally to get right with the law and pay a fine and learn English and get to the back of the line but, you know, ultimately join fully our American community, when — when you’ve got a law that makes sense, you shouldn’t be looking for an excuse not to do it. And I’m going to keep on pushing to make sure it gets done.
Am I going to have to do some work to rebuild confidence around some of our initiatives? Yeah.
But part of — part of this job is, the things that go right, you guys aren’t going to write about. The things that go wrong get prominent attention; that’s how it’s always been. That’s not unique to me as president, and I’m up to the challenge. We’re going to get this done, all right?
Thank you, everybody.